{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:18:55Z","timestamp":1747196335050,"version":"3.40.5"},"reference-count":30,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T00:00:00Z","timestamp":1691625600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"French National Agency for Research on AIDS, Viral Hepatitis and Emerging infectious diseases"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>In Cambodia, traditional medicine was commonly described as being used by pregnant women at two time points: one month before birth and during early postpartum. The present study aims to describe traditional medicine consumption during postpartum phase for women enrolled in the TA PROHM study and to investigate the possible association between traditional medicine consumption and acute liver toxicity. An ethnobotanical survey was conducted in 2 groups of HBV-infected pregnant women (with and without postpartum hepatocellular injury) enrolled in the study. Hepatocellular injury was defined by having Alanine Aminotransferase (ALT) &gt; 2.5 times the Upper Limit of Normal (ULN = 40 U\/L) at the 6<jats:sup>th<\/jats:sup> week postpartum visit. Interviews were done using a standardized questionnaire. Plant samples were collected and later identified by two traditional healers. Chi-square test was used to find the association between hepatocellular injury and traditional medicine consumption or a specific plant species. In total, 75 women were enrolled and 52 (69.3%) used at least one traditional remedy composed of 123 different plants and 12 alcoholic macerations of porcupine stomach. Orally consuming at least one remedy with alcohol was significantly associated with hepatocellular injury (33% <jats:italic>vs<\/jats:italic> 13%, p = 0.034). Among the 123 plants species identified, four were found to be associated with hepatocellular injury, namely <jats:italic>Amphineurion marginatum<\/jats:italic> (Roxb.) D.J.Middleton [Apocynaceae] (p = 0.022), <jats:italic>Selaginella tamariscina<\/jats:italic> (P.Beauv.) Spring [Selaginellaceae] (p = 0.048), <jats:italic>Mitragyna speciosa<\/jats:italic> Korth. [Rubiaceae] (p = 0.099) and <jats:italic>Tetracera indica<\/jats:italic> (Christm. &amp; Panz.) Merr. [Dilleniaceae] (p = 0.079). Consumption of traditional medicine in postpartum is a common practice for women enrolled in the TA PROHM study. Alcohol-based remedies may exacerbate the risk of acute hepatocellular injury in HBV-infected women already exposed to immune restoration. The complex mixtures of herbs need to be further evaluated by in vitro and in vivo studies.<\/jats:p>","DOI":"10.1371\/journal.pone.0288389","type":"journal-article","created":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T17:44:53Z","timestamp":1691689493000},"page":"e0288389","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Traditional medicine consumption in postpartum for HBV-infected women enrolled in the ANRS 12345 TA PROHM study in Cambodia"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6675-0638","authenticated-orcid":true,"given":"Sotheara","family":"Moeung","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Chassagne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie","family":"Goyet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sovann","family":"Nhoeung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynecta","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorina","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2778-8582","authenticated-orcid":true,"given":"Steve","family":"Vilhem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bunnet","family":"Dim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Socheat","family":"Ly","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Sov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vouchleang","family":"Sreng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sokda","family":"Chorn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samsorphea","family":"Chhun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurence","family":"Borand","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sothea","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Segeral","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,8,10]]},"reference":[{"key":"pone.0288389.ref001","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.1016\/S0140-6736(15)61412-X","article-title":"Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013","volume":"386","author":"A Schweitzer","year":"2015","journal-title":"Lancet"},{"key":"pone.0288389.ref002","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1111\/j.1478-3231.2008.01933.x","article-title":"Hepatitis B and pregnancy: an underestimated issue","volume":"291","author":"MM Jonas","year":"2009","journal-title":"Liver Int"},{"key":"pone.0288389.ref003","doi-asserted-by":"crossref","first-page":"5059","DOI":"10.1016\/j.vaccine.2019.06.073","article-title":"Hepatitis B surface antigen seroprevalence among pre- and post-vaccine cohorts in Cambodia, 2017","volume":"37","author":"V Ork","year":"2019","journal-title":"Vaccine"},{"key":"pone.0288389.ref004","unstructured":"Bulletin de la Soci\u00e9t\u00e9 des \u00c9tudes Indochinoises, Tome XL, Nos. 1-2-3-4. 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Deur","year":"2015","journal-title":"Environmental Studies \/ Environmental Science Student Scholarship"},{"key":"pone.0288389.ref018","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1080\/07399330490267477","article-title":"Heat, Balance, Humors, and Ghosts: Postpartum in Cambodia.","volume":"25","author":"P White","year":"2004","journal-title":"Health Care for Women International"},{"key":"pone.0288389.ref019","article-title":"Postpartum phytomedicine and its future in maternal healthcare in Prey Lang, Cambodia.","volume":"15","author":"VH Grape","year":"2016"},{"key":"pone.0288389.ref020","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/j.jep.2013.11.030","article-title":"Medicinal plants for women\u2019s healthcare in southeast Asia: A meta-analysis of their traditional use, chemical constituents, and pharmacology","volume":"151","author":"HJ de Boer","year":"2014","journal-title":"Journal of 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Giles","year":"2015","journal-title":"Gut"},{"key":"pone.0288389.ref024","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1002\/ptr.6020","article-title":"Pregnancy and herbal medicines: An unnecessary risk for women\u2019s health-A narrative review.","volume":"32","author":"LO Bruno","year":"2018","journal-title":"Phytother Res."},{"key":"pone.0288389.ref025","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.jep.2019.01.006","article-title":"Systematic review of published data on herb induced liver injury","volume":"233","author":"J-H Byeon","year":"2019","journal-title":"J Ethnopharmacol"},{"key":"pone.0288389.ref026","doi-asserted-by":"crossref","first-page":"356","DOI":"10.3390\/toxins8120356","article-title":"Dehydropyrrolizidine Alkaloid Toxicity, Cytotoxicity, and Carcinogenicity.","volume":"8","author":"BL 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